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Three New Developments


Email Alert

August 11, 2006

CMS Proposes Policy, Payment Changes for Physicians' Services

On August 8, 2006, CMS announced that it would issue a proposed rule "that would revise payment rates and policies under the Medicare Physician Fee Schedule. These proposals are in addition to the proposed revisions to the work relative value units (RVUs) and proposed changes in the methodology for calculating practice expense RVUs released in a separate proposed notice in the June 29 Federal Register." CMS "projects that it will pay approximately $61.5 billion to 875,000 physicians and other health care professionals in 2007." The proposed rule will be published on August 22, 2006.

View the full press release.

View the proposed rule and associated documents.

CMS will accept comments until October 10, 2006. The final rule will be effective January 1, 2007.

CMS Proposes Changes to Policies and Payment for Outpatient Services and Ambulatory Surgical Centers

On August 8, 2006, CMS announced a "proposed rule for Medicare payment for hospital outpatient services in calendar year 2007 that would implement new steps to make payments more accurate and to promote higher quality and value in outpatient care." The rule also proposes "a major revision of payments for ambulatory surgical centers (ASCs) that would better align payments for surgical procedures provided in ASCs and hospital outpatient departments." The rule is scheduled to be published on August 23, 2006.

View the press release.

View the proposed rule and associated documents.

Comments on the OPPS proposals contained in the rule will be accepted until October 10. The deadline for submission of comments on the revised ASC payment system is extended for an additional 30 days.

Medicare Issues Final Report to Implementing Strategic Plan for Specialty Hospitals

On August 8, 2006, HHS announced a strategic and implementing plan to address issues regarding physician investment in specialty hospitals.

The strategic plan is contained in a Final Report to Congress to implement a provision requiring the development of a strategic and implementing plan from the Deficit eduction Act of 2005 (DRA). The DRA requires the HHS Secretary to develop a "strategic and implementing plan" to address the following issues: (1) proportionality of investment return; (2) bona fide investment; (3) annual disclosure of investment information; (4) the provision by specialty hospitals of (i) care to patients who are eligible for Medicaid (or who are not eligible for Medicaid but who are regarded as such because they receive benefits under a section 1115 waiver)
and (ii) charity care; and (5) appropriate enforcement.

HHS has not yet posted the final report on any of its websites, but the report will likely be available here:

View the press release.

View the fact sheet summarizing the provisions of the Final Report.

We would like to thank Richard Korman (Saint Joseph Regional Medical Center, Mishawaka, IN) for providing this email alert.

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